肥胖对中枢性性早熟女童GnRH激发试验促黄体生成素峰值及相关激素的影响

Effects of obesity on peak level of luteinizing hormone in gonadotropin-releasing hormone agonist test and obesity-related hormones in girls with central precocious puberty

摘要:

目的 探讨肥胖对中枢性性早熟女童GnRH激发试验促黄体生成素(LH)峰值及相关激素的影响。方法 选取我院2012~2014年完成GnRH激发试验的中枢性性早熟女童333例,根据体重指数(BMI)分为正常体重组(n=123)、超重组(n=108)和肥胖组(n=102),并对3组性发育指标进行比较分析。再分别从各组中随机抽取20例,检测血清瘦素(leptin)、性激素结合蛋白(SHBG)、神经激肽B(neurokini B)和吻素(kisspeptin)水平,Pearson相关分析分析BMI与各激素水平的相关性。结果 各组平均诊断年龄差异无统计学意义,但超重及肥胖组的骨龄显著大于正常体重组(P< 0.05)。正常体重组血清LH激发峰值、SHBG水平显著高于超重及肥胖组,leptin及neurokiniB水平显著低于超重及肥胖组(P< 0.05)。BMI与GnRH激发试验LH峰值、SHBG水平呈负相关(P< 0.05),与leptin和neurokiniB水平呈正相关(P< 0.05)。结论 在分析性早熟女童GnRH激发试验结果及相关激素水平时需考虑BMI对结果的影响。

Abstract:

Objective To explore the effects of obesity on the peak level of luteinizing hormone (LH) in the gonadotropin-releasing hormone (GnRH) agonist test and obesity-related hormones in girls with central precocious puberty (CPP). Methods Three hundred and thirty-three girls with CPP who underwent the GnRH agonist test between 2012 and 2014 were classified into three groups: normal weight (n=123), overweight (n=108), and obesity (n=102), according to body mass index (BMI). The sexual development indices were compared between the three groups. Twenty girls were randomly selected from each group for evaluation of the serum levels of leptin, sex hormone binding globulin (SHBG), neurokinin B, and kisspeptin. The correlation of BMI with the levels of various hormones was assessed using Pearson correlation analysis. Results There was no significant difference in mean age at diagnosis between the three groups; however, the bone age was significantly higher in the overweight and obesity groups than in the normal weight group (P< 0.05). The peak level of LH in the GnRH agonist test and SHBG level in the normal weight group were significantly higher than those in the overweight and the obesity groups, while the serum levels of leptin and neurokinin B were significantly lower in the normal weight group than in the overweight and the obesity groups (P< 0.05). BMI was negatively correlated with the peak level of LH in the GnRH agonist test and SHBG level (P< 0.05), and positively correlated with the levels of leptin and neurokinin B (P< 0.05). Conclusions The effects of BMI on the result of the GnRH agonist test and levels of obesity-related hormones should be taken into account in girls with precocious puberty.